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Факторы риска вертикальной передачи вируса гепатита B и эффективность различных схем профилактики у беременных

https://dx.doi.org/10.51350/zdravkg2025.4.12.9.73.79
Факторы риска вертикальной передачи вируса гепатита B и эффективность различных схем профилактики у беременных
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Аннотация Об авторах Список литературы

Аннотация

Введение. Вертикальная передача вируса гепатита B остается актуальной проблемой перинатальной медицины, определяющей риск формирования хронической HBV-инфекции у ребенка. Цель исследования. Определить ключевые факторы риска вертикальной передачи HBV и оценить эффективность различных схем профилактики инфицирования новорожденных. Материалы и методы. Проведен ретроспективный анализ данных 231 беременной с хронической HBV-инфекцией. Оценивались серологические, молекулярно-биологические и лабораторные показатели, включая индекс APRI. Статистическая обработка выполнена с использованием критерия χ² и теста Манна-Уитни. Результаты и обсуждение. Повышение APRI у беременных с хронической HBV-инфекцией (p < 0,0001) определено как основной фактор риска HBsAg-позитивного статуса новорожденных, что подчеркивает значение оценки фиброза при прогнозировании вертикальной передачи. Комбинированная профилактика (вакцина + HBIG) обеспечивала полную защиту от инфицирования, тогда как при изолированной вакцинации HBsAg выявлен у 13,1 % детей (p = 0,009). Вертикальная передача возможна на всех стадиях хронической инфекции, включая HBeAg-негативные формы с низким уровнем виремии (< 200 000 МЕ/мл). Раннее назначение тенофовира (TDF) в сочетании с вакцинацией эффективно предотвращало передачу вируса и может служить альтернативой схемам с HBIG. Заключение. Совмещение противовирусной терапии и специфической иммунопрофилактики является наиболее эффективной стратегией снижения риска вертикальной передачи HBV.

Об авторах

Турсунбаева Мира Сабирбековна, ассистент кафедры инфекционных болезней Международной высшей школы медицины, Бишкек, Кыргызская Республика

Tursunbaeva Mira Sabirbekovna, Assistant, Department of Infectious Diseases, International Higher School of Medicine, Bishkek, Kyrgyz Republic

Турсунбаева Мира Сабирбековна, Эл аралык жогорку медицина мектебинин жугуштуу оорулар кафедрасынын ассистенти, Бишкек, Кыргыз Республикасы

Список литературы

1. World Health Organization. Prevention of mother-to-child transmission of hepatitis B virus: guidelines on antiviral prophylaxis
in pregnancy. Geneva: WHO; 2020. https://www.who.int/publications/i/item/978-92-4-000270-8
2. Tran TT, Ahn J, Reau NS. Treatment and prevention of viral hepatitis in pregnancy. Clin Liver Dis. 2021;25(2):237–254.
https://pmc.ncbi.nlm.nih.gov/articles/PMC8907340
3. European Association for the Study of the Liver (EASL). EASL Clinical Practice Guidelines: Management of chronic hepatitis
B virus infection. J Hepatol. 2023;79(1):S1–S33. https://www.journal-of-hepatology.eu/article/S0168-8278(23)00181-2/fulltext
4. Zhang J, et al. A scoping review of hepatitis B guidelines to reduce mother-to-child transmission. Lancet Reg Health West Pac.
2025;43:100772. https://pmc.ncbi.nlm.nih.gov/articles/PMC11772972
5. World Health Organization. Hepatitis B vaccines: WHO position paper. Wkly Epidemiol Rec. 2017;92(27):369–392.
https://www.who.int/publications/i/item/WER9227
6. Zhou YH, Hu Y, Liu X, Yang H; CSOG MFM Committee. CSOG MFM Committee Guideline: Management of Hepatitis B
During Pregnancy and Prevention of Mother-to-Child Transmission of Hepatitis B Virus (2020). Maternal Fetal Med. 2021;3(1):7–
17. https://journals.lww.com/mfm/fulltext/2021/01000/csog_mfm_committee_guideline__management_of.3.aspx
7. World Health Organization. WHO Guidelines on hepatitis B and C testing and antiviral prophylaxis in pregnancy. Geneva: WHO;
2021. https://www.ncbi.nlm.nih.gov/books/NBK561126
8. Wai CT, et al. A simple noninvasive index can predict both significant fibrosis and cirrhosis in patients with chronic hepatitis B.

Hepatology. 2003;38(2):518–526. https://pubmed.ncbi.nlm.nih.gov/12883497
9. Johnson PJ, et al. Assessment of liver function in patients with hepatocellular carcinoma: ALBI grade and score. J Clin Oncol.
2015;33(6):550–558. https://pubmed.ncbi.nlm.nih.gov/25512453
10. Wiseman E, et al. Perinatal transmission of hepatitis B virus: risk and prevention. J Hepatol. 2009;51(3):513–528. https://pub
med.ncbi.nlm.nih.gov/19560225
11. Pan CQ, et al. Tenofovir to prevent hepatitis B transmission in mothers with high viral load. N Engl J Med. 2016;374(24):2324–
2334. https://www.nejm.org/doi/full/10.1056/NEJMoa1508660
12. Liu J, et al. Maternal hepatic inflammation and risk of perinatal transmission of hepatitis B virus. Clin Infect Dis. 2020;71(3):681–689. https://pubmed.ncbi.nlm.nih.gov/31426260

1. World Health Organization. Prevention of mother-to-child transmission of hepatitis B virus: guidelines on antiviral prophylaxis
in pregnancy. Geneva: WHO; 2020. https://www.who.int/publications/i/item/978-92-4-000270-8
2. Tran TT, Ahn J, Reau NS. Treatment and prevention of viral hepatitis in pregnancy. Clin Liver Dis. 2021;25(2):237–254.
https://pmc.ncbi.nlm.nih.gov/articles/PMC8907340
3. European Association for the Study of the Liver (EASL). EASL Clinical Practice Guidelines: Management of chronic hepatitis
B virus infection. J Hepatol. 2023;79(1):S1–S33. https://www.journal-of-hepatology.eu/article/S0168-8278(23)00181-2/fulltext
4. Zhang J, et al. A scoping review of hepatitis B guidelines to reduce mother-to-child transmission. Lancet Reg Health West Pac.
2025;43:100772. https://pmc.ncbi.nlm.nih.gov/articles/PMC11772972
5. World Health Organization. Hepatitis B vaccines: WHO position paper. Wkly Epidemiol Rec. 2017;92(27):369–392.
https://www.who.int/publications/i/item/WER9227
6. Zhou YH, Hu Y, Liu X, Yang H; CSOG MFM Committee. CSOG MFM Committee Guideline: Management of Hepatitis B
During Pregnancy and Prevention of Mother-to-Child Transmission of Hepatitis B Virus (2020). Maternal Fetal Med. 2021;3(1):7–
17. https://journals.lww.com/mfm/fulltext/2021/01000/csog_mfm_committee_guideline__management_of.3.aspx
7. World Health Organization. WHO Guidelines on hepatitis B and C testing and antiviral prophylaxis in pregnancy. Geneva: WHO;
2021. https://www.ncbi.nlm.nih.gov/books/NBK561126
8. Wai CT, et al. A simple noninvasive index can predict both significant fibrosis and cirrhosis in patients with chronic hepatitis B.

Hepatology. 2003;38(2):518–526. https://pubmed.ncbi.nlm.nih.gov/12883497
9. Johnson PJ, et al. Assessment of liver function in patients with hepatocellular carcinoma: ALBI grade and score. J Clin Oncol.
2015;33(6):550–558. https://pubmed.ncbi.nlm.nih.gov/25512453
10. Wiseman E, et al. Perinatal transmission of hepatitis B virus: risk and prevention. J Hepatol. 2009;51(3):513–528. https://pub
med.ncbi.nlm.nih.gov/19560225
11. Pan CQ, et al. Tenofovir to prevent hepatitis B transmission in mothers with high viral load. N Engl J Med. 2016;374(24):2324–
2334. https://www.nejm.org/doi/full/10.1056/NEJMoa1508660
12. Liu J, et al. Maternal hepatic inflammation and risk of perinatal transmission of hepatitis B virus. Clin Infect Dis. 2020;71(3):681–689. https://pubmed.ncbi.nlm.nih.gov/31426260

1. World Health Organization. Prevention of mother-to-child transmission of hepatitis B virus: guidelines on antiviral prophylaxis
in pregnancy. Geneva: WHO; 2020. https://www.who.int/publications/i/item/978-92-4-000270-8
2. Tran TT, Ahn J, Reau NS. Treatment and prevention of viral hepatitis in pregnancy. Clin Liver Dis. 2021;25(2):237–254.
https://pmc.ncbi.nlm.nih.gov/articles/PMC8907340
3. European Association for the Study of the Liver (EASL). EASL Clinical Practice Guidelines: Management of chronic hepatitis
B virus infection. J Hepatol. 2023;79(1):S1–S33. https://www.journal-of-hepatology.eu/article/S0168-8278(23)00181-2/fulltext
4. Zhang J, et al. A scoping review of hepatitis B guidelines to reduce mother-to-child transmission. Lancet Reg Health West Pac.
2025;43:100772. https://pmc.ncbi.nlm.nih.gov/articles/PMC11772972
5. World Health Organization. Hepatitis B vaccines: WHO position paper. Wkly Epidemiol Rec. 2017;92(27):369–392.
https://www.who.int/publications/i/item/WER9227
6. Zhou YH, Hu Y, Liu X, Yang H; CSOG MFM Committee. CSOG MFM Committee Guideline: Management of Hepatitis B
During Pregnancy and Prevention of Mother-to-Child Transmission of Hepatitis B Virus (2020). Maternal Fetal Med. 2021;3(1):7–
17. https://journals.lww.com/mfm/fulltext/2021/01000/csog_mfm_committee_guideline__management_of.3.aspx
7. World Health Organization. WHO Guidelines on hepatitis B and C testing and antiviral prophylaxis in pregnancy. Geneva: WHO;
2021. https://www.ncbi.nlm.nih.gov/books/NBK561126
8. Wai CT, et al. A simple noninvasive index can predict both significant fibrosis and cirrhosis in patients with chronic hepatitis B.

Hepatology. 2003;38(2):518–526. https://pubmed.ncbi.nlm.nih.gov/12883497
9. Johnson PJ, et al. Assessment of liver function in patients with hepatocellular carcinoma: ALBI grade and score. J Clin Oncol.
2015;33(6):550–558. https://pubmed.ncbi.nlm.nih.gov/25512453
10. Wiseman E, et al. Perinatal transmission of hepatitis B virus: risk and prevention. J Hepatol. 2009;51(3):513–528. https://pub
med.ncbi.nlm.nih.gov/19560225
11. Pan CQ, et al. Tenofovir to prevent hepatitis B transmission in mothers with high viral load. N Engl J Med. 2016;374(24):2324–
2334. https://www.nejm.org/doi/full/10.1056/NEJMoa1508660
12. Liu J, et al. Maternal hepatic inflammation and risk of perinatal transmission of hepatitis B virus. Clin Infect Dis. 2020;71(3):681–689. https://pubmed.ncbi.nlm.nih.gov/31426260

Ключевые слова
Беременность , Профилактика , Вирусный гепатит В (ВГВ) , Вертикальная передача , APRI , HBIG , Тенофовир
Для цитирования

Турсунбаева М.С. Факторы риска вертикальной передачи вируса гепатита B и эффективность различных схем профилактики у беременных.Научно-практический журнал«Здравоохранение Кыргызс- тана» 2025, № 4, с. 73-79. https://dx.doi.org/10.51350/zdravkg2025.4.12.9.73.79
For citation
Tursunbaeva M.S. Risk factors for vertical transmission of HBV infection and strategies for its prevention. Scientific practical journal “Health care of Kyrzstan” 2025, No.4, p. 73-79. https://dx.doi.org/10.51350/zdravkg2025.4.12.9.73.79
Цитата үчүн

Турсунбаева М.С. Кош бойлуу аялдарда В гепатит вирусунун вертикалдык жугушунун коркунуч факторлору жана алдын алуу ыкмаларынын натыйжалуулугу. "Кыргызстандын саламаттык сактоо" илимий-практикалык журналы
2025, № 4, б. 73-79. https://dx.doi.org/10.51350/zdravkg2025.4.12.9.73.79
Авторы Турсунбаева М.С.
Ссылка doi.org https://dx.doi.org/10.51350/zdravkg2025.4.12.9.73.79
Страницы 73-79
Ключевые слова Беременность, Профилактика, Вирусный гепатит В (ВГВ), Вертикальная передача, APRI, HBIG, Тенофовир
Русский
Об авторах

Турсунбаева Мира Сабирбековна, ассистент кафедры инфекционных болезней Международной высшей школы медицины, Бишкек, Кыргызская Республика

Полный текст

PDF (RUS)
Список литературы

1. World Health Organization. Prevention of mother-to-child transmission of hepatitis B virus: guidelines on antiviral prophylaxis
in pregnancy. Geneva: WHO; 2020. https://www.who.int/publications/i/item/978-92-4-000270-8
2. Tran TT, Ahn J, Reau NS. Treatment and prevention of viral hepatitis in pregnancy. Clin Liver Dis. 2021;25(2):237–254.
https://pmc.ncbi.nlm.nih.gov/articles/PMC8907340
3. European Association for the Study of the Liver (EASL). EASL Clinical Practice Guidelines: Management of chronic hepatitis
B virus infection. J Hepatol. 2023;79(1):S1–S33. https://www.journal-of-hepatology.eu/article/S0168-8278(23)00181-2/fulltext
4. Zhang J, et al. A scoping review of hepatitis B guidelines to reduce mother-to-child transmission. Lancet Reg Health West Pac.
2025;43:100772. https://pmc.ncbi.nlm.nih.gov/articles/PMC11772972
5. World Health Organization. Hepatitis B vaccines: WHO position paper. Wkly Epidemiol Rec. 2017;92(27):369–392.
https://www.who.int/publications/i/item/WER9227
6. Zhou YH, Hu Y, Liu X, Yang H; CSOG MFM Committee. CSOG MFM Committee Guideline: Management of Hepatitis B
During Pregnancy and Prevention of Mother-to-Child Transmission of Hepatitis B Virus (2020). Maternal Fetal Med. 2021;3(1):7–
17. https://journals.lww.com/mfm/fulltext/2021/01000/csog_mfm_committee_guideline__management_of.3.aspx
7. World Health Organization. WHO Guidelines on hepatitis B and C testing and antiviral prophylaxis in pregnancy. Geneva: WHO;
2021. https://www.ncbi.nlm.nih.gov/books/NBK561126
8. Wai CT, et al. A simple noninvasive index can predict both significant fibrosis and cirrhosis in patients with chronic hepatitis B.

Hepatology. 2003;38(2):518–526. https://pubmed.ncbi.nlm.nih.gov/12883497
9. Johnson PJ, et al. Assessment of liver function in patients with hepatocellular carcinoma: ALBI grade and score. J Clin Oncol.
2015;33(6):550–558. https://pubmed.ncbi.nlm.nih.gov/25512453
10. Wiseman E, et al. Perinatal transmission of hepatitis B virus: risk and prevention. J Hepatol. 2009;51(3):513–528. https://pub
med.ncbi.nlm.nih.gov/19560225
11. Pan CQ, et al. Tenofovir to prevent hepatitis B transmission in mothers with high viral load. N Engl J Med. 2016;374(24):2324–
2334. https://www.nejm.org/doi/full/10.1056/NEJMoa1508660
12. Liu J, et al. Maternal hepatic inflammation and risk of perinatal transmission of hepatitis B virus. Clin Infect Dis. 2020;71(3):681–689. https://pubmed.ncbi.nlm.nih.gov/31426260
Для цитирования

Турсунбаева М.С. Факторы риска вертикальной передачи вируса гепатита B и эффективность различных схем профилактики у беременных.Научно-практический журнал«Здравоохранение Кыргызс- тана» 2025, № 4, с. 73-79. https://dx.doi.org/10.51350/zdravkg2025.4.12.9.73.79
Английский
About authors

Tursunbaeva Mira Sabirbekovna, Assistant, Department of Infectious Diseases, International Higher School of Medicine, Bishkek, Kyrgyz Republic
Full text

PDF (RUS)
References

1. World Health Organization. Prevention of mother-to-child transmission of hepatitis B virus: guidelines on antiviral prophylaxis
in pregnancy. Geneva: WHO; 2020. https://www.who.int/publications/i/item/978-92-4-000270-8
2. Tran TT, Ahn J, Reau NS. Treatment and prevention of viral hepatitis in pregnancy. Clin Liver Dis. 2021;25(2):237–254.
https://pmc.ncbi.nlm.nih.gov/articles/PMC8907340
3. European Association for the Study of the Liver (EASL). EASL Clinical Practice Guidelines: Management of chronic hepatitis
B virus infection. J Hepatol. 2023;79(1):S1–S33. https://www.journal-of-hepatology.eu/article/S0168-8278(23)00181-2/fulltext
4. Zhang J, et al. A scoping review of hepatitis B guidelines to reduce mother-to-child transmission. Lancet Reg Health West Pac.
2025;43:100772. https://pmc.ncbi.nlm.nih.gov/articles/PMC11772972
5. World Health Organization. Hepatitis B vaccines: WHO position paper. Wkly Epidemiol Rec. 2017;92(27):369–392.
https://www.who.int/publications/i/item/WER9227
6. Zhou YH, Hu Y, Liu X, Yang H; CSOG MFM Committee. CSOG MFM Committee Guideline: Management of Hepatitis B
During Pregnancy and Prevention of Mother-to-Child Transmission of Hepatitis B Virus (2020). Maternal Fetal Med. 2021;3(1):7–
17. https://journals.lww.com/mfm/fulltext/2021/01000/csog_mfm_committee_guideline__management_of.3.aspx
7. World Health Organization. WHO Guidelines on hepatitis B and C testing and antiviral prophylaxis in pregnancy. Geneva: WHO;
2021. https://www.ncbi.nlm.nih.gov/books/NBK561126
8. Wai CT, et al. A simple noninvasive index can predict both significant fibrosis and cirrhosis in patients with chronic hepatitis B.

Hepatology. 2003;38(2):518–526. https://pubmed.ncbi.nlm.nih.gov/12883497
9. Johnson PJ, et al. Assessment of liver function in patients with hepatocellular carcinoma: ALBI grade and score. J Clin Oncol.
2015;33(6):550–558. https://pubmed.ncbi.nlm.nih.gov/25512453
10. Wiseman E, et al. Perinatal transmission of hepatitis B virus: risk and prevention. J Hepatol. 2009;51(3):513–528. https://pub
med.ncbi.nlm.nih.gov/19560225
11. Pan CQ, et al. Tenofovir to prevent hepatitis B transmission in mothers with high viral load. N Engl J Med. 2016;374(24):2324–
2334. https://www.nejm.org/doi/full/10.1056/NEJMoa1508660
12. Liu J, et al. Maternal hepatic inflammation and risk of perinatal transmission of hepatitis B virus. Clin Infect Dis. 2020;71(3):681–689. https://pubmed.ncbi.nlm.nih.gov/31426260
For citation
Tursunbaeva M.S. Risk factors for vertical transmission of HBV infection and strategies for its prevention. Scientific practical journal “Health care of Kyrzstan” 2025, No.4, p. 73-79. https://dx.doi.org/10.51350/zdravkg2025.4.12.9.73.79
Кыргызский
Авторлор жөнүндө

Турсунбаева Мира Сабирбековна, Эл аралык жогорку медицина мектебинин жугуштуу оорулар кафедрасынын ассистенти, Бишкек, Кыргыз Республикасы
Шилтемелер

1. World Health Organization. Prevention of mother-to-child transmission of hepatitis B virus: guidelines on antiviral prophylaxis
in pregnancy. Geneva: WHO; 2020. https://www.who.int/publications/i/item/978-92-4-000270-8
2. Tran TT, Ahn J, Reau NS. Treatment and prevention of viral hepatitis in pregnancy. Clin Liver Dis. 2021;25(2):237–254.
https://pmc.ncbi.nlm.nih.gov/articles/PMC8907340
3. European Association for the Study of the Liver (EASL). EASL Clinical Practice Guidelines: Management of chronic hepatitis
B virus infection. J Hepatol. 2023;79(1):S1–S33. https://www.journal-of-hepatology.eu/article/S0168-8278(23)00181-2/fulltext
4. Zhang J, et al. A scoping review of hepatitis B guidelines to reduce mother-to-child transmission. Lancet Reg Health West Pac.
2025;43:100772. https://pmc.ncbi.nlm.nih.gov/articles/PMC11772972
5. World Health Organization. Hepatitis B vaccines: WHO position paper. Wkly Epidemiol Rec. 2017;92(27):369–392.
https://www.who.int/publications/i/item/WER9227
6. Zhou YH, Hu Y, Liu X, Yang H; CSOG MFM Committee. CSOG MFM Committee Guideline: Management of Hepatitis B
During Pregnancy and Prevention of Mother-to-Child Transmission of Hepatitis B Virus (2020). Maternal Fetal Med. 2021;3(1):7–
17. https://journals.lww.com/mfm/fulltext/2021/01000/csog_mfm_committee_guideline__management_of.3.aspx
7. World Health Organization. WHO Guidelines on hepatitis B and C testing and antiviral prophylaxis in pregnancy. Geneva: WHO;
2021. https://www.ncbi.nlm.nih.gov/books/NBK561126
8. Wai CT, et al. A simple noninvasive index can predict both significant fibrosis and cirrhosis in patients with chronic hepatitis B.

Hepatology. 2003;38(2):518–526. https://pubmed.ncbi.nlm.nih.gov/12883497
9. Johnson PJ, et al. Assessment of liver function in patients with hepatocellular carcinoma: ALBI grade and score. J Clin Oncol.
2015;33(6):550–558. https://pubmed.ncbi.nlm.nih.gov/25512453
10. Wiseman E, et al. Perinatal transmission of hepatitis B virus: risk and prevention. J Hepatol. 2009;51(3):513–528. https://pub
med.ncbi.nlm.nih.gov/19560225
11. Pan CQ, et al. Tenofovir to prevent hepatitis B transmission in mothers with high viral load. N Engl J Med. 2016;374(24):2324–
2334. https://www.nejm.org/doi/full/10.1056/NEJMoa1508660
12. Liu J, et al. Maternal hepatic inflammation and risk of perinatal transmission of hepatitis B virus. Clin Infect Dis. 2020;71(3):681–689. https://pubmed.ncbi.nlm.nih.gov/31426260
Цитата үчүн

Турсунбаева М.С. Кош бойлуу аялдарда В гепатит вирусунун вертикалдык жугушунун коркунуч факторлору жана алдын алуу ыкмаларынын натыйжалуулугу. "Кыргызстандын саламаттык сактоо" илимий-практикалык журналы
2025, № 4, б. 73-79. https://dx.doi.org/10.51350/zdravkg2025.4.12.9.73.79
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